The roles of pathology in targeted therapy of women with gynecologic cancers Journal Article
| Authors: | Murali, R.; Grisham, R. N.; Soslow, R. A. |
| Article Title: | The roles of pathology in targeted therapy of women with gynecologic cancers |
| Abstract: | The role of the pathologist in the multidisciplinary management of women with gynecologic cancer has evolved substantially over the past decade. Pathologists’ evaluation of parameters such as pathologic stage, histologic subtype, grade and microsatellite instability, and their identification of patients at risk for Lynch syndrome have become essential components of diagnosis, prognostic assessment and determination of optimal treatment of affected women. Despite the use of multimodality treatment and combination cytotoxic chemotherapy, the prognosis of women with advanced-stage gynecologic cancer is often poor. Therefore, expanding the arsenal of available systemic therapies with targeted therapeutic agents is appealing. Anti-angiogenic therapies, immunotherapy and poly ADP ribose polymerase (PARP) inhibitors are now routinely used for the treatment of advanced gynecologic cancer, and many more are under investigation. Pathologists remain important in the clinical management of patients with targeted therapy, by identifying potentially targetable tumors on the basis of their pathologic phenotype, by assessing biomarkers that are predictive of response to targeted therapy (e.g. microsatellite instability, PD1/PDL1 expression), and by monitoring treatment response and resistance. Pathologists are also vital to research efforts exploring novel targeted therapies by identifying homogenous subsets of tumors for more reliable and meaningful analyses, and by confirming expression in tumor tissues of novel targets identified in genomic, epigenetic or other screening studies. In the era of precision gynecologic oncology, the roles of pathologists in the discovery, development and implementation of targeted therapeutic strategies remain as central as they are for traditional (surgery-chemotherapy-radiotherapy) management of women with gynecologic cancers. © 2017 Elsevier Inc. |
| Keywords: | mitogen activated protein kinase; protein expression; treatment response; gene mutation; review; angiogenesis inhibitor; cancer combination chemotherapy; treatment; antineoplastic agent; biological marker; phenotype; homologous recombination; cancer immunotherapy; pathology; ovary; mismatch repair; microsatellite instability; ovary carcinoma; nicotinamide adenine dinucleotide adenosine diphosphate ribosyltransferase inhibitor; targeted therapy; gynecologic cancer; cervix; endometrium; programmed death 1 ligand 1; programmed death 1 receptor; molecularly targeted therapy; female genital tract cancer; cancer prognosis; cancer; human; priority journal; precision medicine; pole gene |
| Journal Title: | Gynecologic Oncology |
| Volume: | 148 |
| Issue: | 1 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2018-01-01 |
| Start Page: | 213 |
| End Page: | 221 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2017.11.020 |
| PROVIDER: | scopus |
| PMCID: | PMC5756523 |
| PUBMED: | 29174566 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 6 February 2018 -- Source: Scopus |
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